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Talking About Alzheimer's

Posted Nov 25 2009 12:00am

Many physicians fear that revealing a diagnosis of dementia would only further upset an already troubled patient, but a study from Washington University in St. Louis found quite the opposite. When it comes to a diagnosis of Alzheimer's disease, knowing the truth as soon as possible appears to be the better approach, potentially improving the emotional wellbeing of both patients and their caregivers, the researchers report.

Medical advances have made it possible to diagnose Alzheimer's at very early stages, but a study published in the Journal of the American Geriatrics Society found that about half of all physicians were reluctant to inform patients of an Alzheimer's diagnosis.

The study followed 90 individuals and their caregivers as they came to the Alzheimer's Disease Research Center at Washington University's School of Medicine for an evaluation. Sixty nine percent eventually got a diagnosis of Alzheimer's disease, but no significant changes in depression were noted and anxiety decreased substantially.

"The major finding is that both patients and their families feel relief, not increased anxiety, upon learning the diagnosis," says study co-author John C. Morris, M.D., Director of the Alzheimer's Disease Research Center. This was true regardless of the degree of impairment.

"Nobody wants to hear the diagnosis of Alzheimer's disease, but even that is preferable to recognizing there's a problem and not knowing what it is. At least having the diagnosis allows people to make plans for the future, including treatment as appropriate." One reason an Alzheimer's diagnosis can be comforting to both family members and patients, suggests Carpenter, is that it provides an explanation for what's been going on with the patient. Caregivers, he says, are often quick to attribute symptoms of dementia to the person, rather than the disease, and patients wonder if they are going "crazy."

Bottom line: Knowledge is power, and earlier diagnoses allow for earlier interventions to delay the effects of Alzheimer's and dementia. Medications currently on the market can slightly delay symptoms in some patients and may delay institutionalization. Perhaps more importantly, providing a diagnosis as early as possible gives people a chance to prepare for what is coming. "They know that things are going to get worse rather than better, and they know that there's going to come a time when they're not going to be able to do the things they can do now," says Carpenter. "They can get ready for what's coming, and we can connect them to support services. We can get their family ready, so they'll be better prepared."